调脂增寿汤治疗血脂异常的临床研究
|
摘要
目的：观察中药复方调脂增寿汤对血脂异常患者血脂系列、动脉硬化指数、非高密度脂蛋白胆固醇的临床疗效及其对C-反应蛋白和同型半胱氨酸的影响，确认调脂增寿汤对血脂异常的治疗作用，及对冠心病等心脑血管疾病的预防和治疗作用，并对该药的安全性进行评价。
材料和方法：诊断标准根据我国《血脂异常防治建议》及参考美国成人胆固醇教育计划(NCEP)等为标准，中医辨证分型主要参考陈可冀主编的《实用中西医结合内科学》为标准。
本研究按患者就诊顺序的先后，将病人随机分为中药组、西药组及中西药结合组。病例资料完整患者共120例，其中中药组43例，西药组40例，中西药组37例。中药组给予调脂增寿汤，西药组给予普伐他汀片，中西药组给予调脂增寿汤和普伐他汀片，药物剂量、组成及服用法均相同，各治疗8周。以胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c)、载脂蛋白A_I(ApoA_I)、载脂蛋白B_(100)(ApoB_(100))、动脉硬化指数[(TC—HDL-c)／HDL-c]、非高密度脂蛋白胆固醇(non-HDL-c)、同型半胱氨酸(Hcy)、C-反应蛋白(CRP)等为观察指标，在服药前后进行上述各项检查，并对肝功、肾功、电解质、血糖、转氨酶、血常规、尿常规等进行测定。分析调脂增寿汤、普伐他汀片及二者合用时用药前后的各项指标变化，比较两药的治疗效果，评定调
军医进修学院硕士论文中文摘要
脂增寿汤对血脂异常的治疗作用，进行该药的安全性评价。
结果:调脂增寿汤治疗血脂异常的临床总体有效率为83.72%。与普
伐他汀片的临床调脂疗效无显著性差异，而调脂增寿汤配合普伐他汀片的
临床调脂疗效则更明显;调脂增寿汤与普伐他汀片在降低TC、TG、LDLc，
升高APoA:方面差异无显著性，而调脂增寿汤可显著升高HDL一，降低
A训Bloo;调脂增寿汤与普伐他汀片均可有效降低动脉硬化指数及非高密
度脂蛋白胆固醇;调脂增寿汤与普伐他汀片均可有效降低血脂异常患者的
CRP，而调脂增寿汤还可显著降低血脂异常患者Hcy。血脂异常患者以痰
浊中阻型和气滞血癖型为主要证型，痰浊、血癖为主要病因病机。调脂增
寿汤治疗血脂异常不良反应发生率低，患者耐受性良好。
结论:调脂增寿汤治疗血脂异常临床疗效确切，能有效升高HDL一c，
降低APoB100，可有效预防和治疗心脑血管疾病及相关病变，且不良反应
发生率低，具有推广价值。
Objectives: To observe the clinical curative effect of Tiaozhi Zengshou Decoction on blood lipids, atheromatous index, non-high density lipoprotein-cholesterol, C-reactive protein and homocystine in patients with dyslipidaemia. To validate it's therapeutical effect on dyslipidaemia and it's preventive and curative effect on coronary heart disease and cardiovascular and cerebrovascular diseases and to assess the safety of Tiaozhi Zengshou Decoction.
Methods: The diagnosis standard were "Prevention, detection, evaluation, and treatment of dyslipidaemia" and "National cholesterol education program(NCEP)". Traditional Chinese Medicine differentiation refer to Chen Keji's "Practical internal medicine of combination of TCM and western medicine".
There are only 120 patients with dyslipidaemia who have whole data. Patients with their coming order were randomly divided into traditional Chinese medicine group receiving Tiaozhi Zengshou Decoction (n=43), western medicine group receiving Pravastatin Tablet (n=40)禄 traditional Chinese medicine and western medicine group receiving Tiaozhi Zengshou Decoction and Pravastatin Tablet (n=37) . The therapeutic course for each group was 8 weeks. The levels of TC, TG, HDL-c, LDL-c, ApoAI, ApoB100,( TC - HDL-c)/HDL-c, non-HDL-c, Hey and CRP were performed as observing
indexes. All indexes were examined at the beginning and the end of treatment At the same time, the patients' liver function, renal function, electrolure, blood sugar, transaminase, routine tests of blood and urine were tested. All these indexes were analyzed to contrast the therapeutical efficacies of each group. The effect of Tiaozhi Zengshou Decoction in regulating blood lipids and adverse effect in patients were observed.
Results: The total effective rate of Tiaozhi Zengshou Decoction group was 83.72%. There was no significant difference between Tiaozhi Zengshou Decoction group and Pravastatin Tablet group about total effective rate. The effect of Tiaozhi Zengshou Decoction and Pravastatin Tablet group was more superior than that of the other two groups. After 8 weeks, the levels of TC, TG, LDL-c, (TC-HDL-c)/HDL-c, non-HDL-c and CRP were significantly decreased and the level of ApoAj were obviously increased in Tiaozhi Zengshou Decoction group and Pravastatin Tablet group. The level of HDL-c were significantly increased and the levels of ApoBioo and Hey were significantly decreased in Tiaozhi Zengshou Decoction group. The main syndrome differentiation of dyslipidaemia are stagnant of qi and blood stasis type and phlegm stagnancy type. The main pathogenic factors and pathogenesis of dyslipidaemia are phlegm and blood stasis. The adverse effect of Tiaozhi Zengshou Decoction was better than that of Pravastatin Tablet group.
Conclusion: Tiaozhi Zengshou Decoction have definite curative effect in treating
patients with dyslipidaemia. It can effectively raise the level of HDL-c, decrease the level of ApoB100, prevent and treat cardiovascular and cerebrovascular disease and have little side effects.
材料和方法：诊断标准根据我国《血脂异常防治建议》及参考美国成人胆固醇教育计划(NCEP)等为标准，中医辨证分型主要参考陈可冀主编的《实用中西医结合内科学》为标准。
本研究按患者就诊顺序的先后，将病人随机分为中药组、西药组及中西药结合组。病例资料完整患者共120例，其中中药组43例，西药组40例，中西药组37例。中药组给予调脂增寿汤，西药组给予普伐他汀片，中西药组给予调脂增寿汤和普伐他汀片，药物剂量、组成及服用法均相同，各治疗8周。以胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c)、载脂蛋白A_I(ApoA_I)、载脂蛋白B_(100)(ApoB_(100))、动脉硬化指数[(TC—HDL-c)／HDL-c]、非高密度脂蛋白胆固醇(non-HDL-c)、同型半胱氨酸(Hcy)、C-反应蛋白(CRP)等为观察指标，在服药前后进行上述各项检查，并对肝功、肾功、电解质、血糖、转氨酶、血常规、尿常规等进行测定。分析调脂增寿汤、普伐他汀片及二者合用时用药前后的各项指标变化，比较两药的治疗效果，评定调
军医进修学院硕士论文中文摘要
脂增寿汤对血脂异常的治疗作用，进行该药的安全性评价。
结果:调脂增寿汤治疗血脂异常的临床总体有效率为83.72%。与普
伐他汀片的临床调脂疗效无显著性差异，而调脂增寿汤配合普伐他汀片的
临床调脂疗效则更明显;调脂增寿汤与普伐他汀片在降低TC、TG、LDLc，
升高APoA:方面差异无显著性，而调脂增寿汤可显著升高HDL一，降低
A训Bloo;调脂增寿汤与普伐他汀片均可有效降低动脉硬化指数及非高密
度脂蛋白胆固醇;调脂增寿汤与普伐他汀片均可有效降低血脂异常患者的
CRP，而调脂增寿汤还可显著降低血脂异常患者Hcy。血脂异常患者以痰
浊中阻型和气滞血癖型为主要证型，痰浊、血癖为主要病因病机。调脂增
寿汤治疗血脂异常不良反应发生率低，患者耐受性良好。
结论:调脂增寿汤治疗血脂异常临床疗效确切，能有效升高HDL一c，
降低APoB100，可有效预防和治疗心脑血管疾病及相关病变，且不良反应
发生率低，具有推广价值。
Objectives: To observe the clinical curative effect of Tiaozhi Zengshou Decoction on blood lipids, atheromatous index, non-high density lipoprotein-cholesterol, C-reactive protein and homocystine in patients with dyslipidaemia. To validate it's therapeutical effect on dyslipidaemia and it's preventive and curative effect on coronary heart disease and cardiovascular and cerebrovascular diseases and to assess the safety of Tiaozhi Zengshou Decoction.
Methods: The diagnosis standard were "Prevention, detection, evaluation, and treatment of dyslipidaemia" and "National cholesterol education program(NCEP)". Traditional Chinese Medicine differentiation refer to Chen Keji's "Practical internal medicine of combination of TCM and western medicine".
There are only 120 patients with dyslipidaemia who have whole data. Patients with their coming order were randomly divided into traditional Chinese medicine group receiving Tiaozhi Zengshou Decoction (n=43), western medicine group receiving Pravastatin Tablet (n=40)禄 traditional Chinese medicine and western medicine group receiving Tiaozhi Zengshou Decoction and Pravastatin Tablet (n=37) . The therapeutic course for each group was 8 weeks. The levels of TC, TG, HDL-c, LDL-c, ApoAI, ApoB100,( TC - HDL-c)/HDL-c, non-HDL-c, Hey and CRP were performed as observing
indexes. All indexes were examined at the beginning and the end of treatment At the same time, the patients' liver function, renal function, electrolure, blood sugar, transaminase, routine tests of blood and urine were tested. All these indexes were analyzed to contrast the therapeutical efficacies of each group. The effect of Tiaozhi Zengshou Decoction in regulating blood lipids and adverse effect in patients were observed.
Results: The total effective rate of Tiaozhi Zengshou Decoction group was 83.72%. There was no significant difference between Tiaozhi Zengshou Decoction group and Pravastatin Tablet group about total effective rate. The effect of Tiaozhi Zengshou Decoction and Pravastatin Tablet group was more superior than that of the other two groups. After 8 weeks, the levels of TC, TG, LDL-c, (TC-HDL-c)/HDL-c, non-HDL-c and CRP were significantly decreased and the level of ApoAj were obviously increased in Tiaozhi Zengshou Decoction group and Pravastatin Tablet group. The level of HDL-c were significantly increased and the levels of ApoBioo and Hey were significantly decreased in Tiaozhi Zengshou Decoction group. The main syndrome differentiation of dyslipidaemia are stagnant of qi and blood stasis type and phlegm stagnancy type. The main pathogenic factors and pathogenesis of dyslipidaemia are phlegm and blood stasis. The adverse effect of Tiaozhi Zengshou Decoction was better than that of Pravastatin Tablet group.
Conclusion: Tiaozhi Zengshou Decoction have definite curative effect in treating
patients with dyslipidaemia. It can effectively raise the level of HDL-c, decrease the level of ApoB100, prevent and treat cardiovascular and cerebrovascular disease and have little side effects.
引文
[1] 陆宗良．脂质代谢异常与冠心病．临床冠心病学，陈在嘉主编．人民军医出版社，1994年4月第1版，61～87．
[2] Scandinavian Simvastatin Survival Study Group. Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study(4S). Lancet, 1994, 344: 1383～1389.
[3] Downs JR, Clearfield M, Whitney E, et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels. JAMA, 1998, 279:1615～1622.
[4] 陆国平，戚文航．冠心病的一级预防．新医学，2000，31(3)：13～14．
[5] Stein EA, Davidson MH, Dobs AS, et al. Efficacy and safety of simvaststin 80mg/day in hypercholesterolemia patients. Am J Cardiol, 1998, 82(3) :311～316.
[6] The Long-term Intervention with Pravastatin in Ischemic Disease(LIPID) Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med, 1998, 339(19) :1349～1357.
[7] 沈丽华，柯开富，李作汉，等．家族聚集性脑梗死发病与低密度脂蛋白胆固醇的相关性．中国临床康复，2003，7(31)：4246～4247．
[8] 尹巧香，赵玉生，陈真．代谢综合征与冠心病及血脂异常的相关性．中国临床康复，2003，7(21)：2916～2917．
[9] 金玉华，祝之明，李彦社，等．血脂紊乱对代谢综合征早期肾功能损害的影响．中国临床康复，2003，7(18)：2515～2517．
[10] Manninen V, Elo MO, Frik MH, et al. Lipid alterations and decline in the incidence of coronary heart disease in the Helsinki heart study. JAMA, 1988, 260:641～651.
[11] Shepherd J, Cobbe SM, Ford I, et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med, 1995, 333 (20) : 1301～1307.
[12] 沈桂英，龚树春．自拟祛脂丸治疗高脂血症43例疗效观察．浙江中医杂志，1997，32(1)，32～32．
[13] 龚一萍，王辛儿．高脂血症与心脉相关性探讨．北京中医药大学学报，2002，25(1)：62～63．
[14] 血脂异常防治对策专题组．血脂异常防治建议．中华心血管病杂志，1997，25(3)：169～175．
[15] Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults(Adult Treatment Panel Ⅲ).Executive Summary of the Third Report of the National Cholesterol Education Program(NCEP).JAMA, 2001, 285:2486～2497.
[16] 田国庆，梁晓春．高脂血症实用中西医结合内科学，陈可冀主编．北京医科大学中国协和医科大学联合出版社出版．1998年第1版，1278～1286．
[17] 刘国仪，胡大一，陶萍，等．心血管药物临床试验评价方法的建议．中华心血管病杂志，1998，26(1)：5～11．
[18] Larosa JC, He J, Vupputuri S. Effect of statin on risk of coronary disease: A meta-analysis of randomized controlled trials. JAMA, 1999, 282:2340～2346.
[19] 王治宽，孟海燕．从痰论治血脂异常浅析．中医药学刊，2004，22(1)：120～121．
[20] 陶晋舆，吕环，张秋菊，等．泽泻抗动脉粥样硬化作用系列研究(二)．北京中医学院学报，1991，14(6)：51～53．
[21] 沈奇桂，朱寿民．决明子对实验性高胆固醇血症和动脉粥样硬化的抑制作用及其机理探讨．浙江医科大学学报，1993，22(6)：246～249．
[22] 沃兴德，高承贤，洪行球，等．姜黄醇提取物对兔食饵性高脂血症的实验研究．浙江中医学院学报，1999，23(1)：16～18．
[23] 沃兴德，洪行球，魏佳萍，等．姜黄醇提取物对高脂血症患者脂代谢及肝肾功能的影响．浙江中医学院学报，1999，23(1)：20～22．
[24] 李小鹰，王培仁，邵建华，等．静脉注射葛根素对犬急性心肌梗塞范围的影响．山东医学院学报，1984，22(3)：9～16．
[25] 吕欣然，陈淑梅，孙塘．葛根素对β-肾上腺素能受体阻滞作用的研究．药学学报，1980，15(4)：218～221．
[26] 曹慧，周爽，方邦江，等．葛根素对自发性高血压大鼠血脂及层粘连蛋白的影
响．医学理论与实践，2003，16(3)：254～255．
[27] 华一俐，张融瑞，仇健明，等．中药桑寄生不同提取液的降脂作用研究．南京中医药大学学报，1995，11(2)：86～86．
[28] 李贵海，孙敬勇，张希林，等．山楂降血脂有效成分的实验研究．中草药，2002，33(1)：50～52．
[29] 潘娟华，倪立坚．丹参对血液系统及血脂作用的研究进展．海峡药学，1998，10(2)：79～79．
[30] 陶波，帅景贤，吴风莲．荷叶水煎剂对高血脂症大鼠血脂及血液流变学的影响．中医药学报，2000，28(6)：55～56．
[31] 龚康敏，历兰娜，姚雪梅，等．荷叶合剂对小鼠及高脂血症大鼠血脂代谢的研究．中国中医药科技，1998，5(5)：294～295．
[32] 李广勋．中药药理毒理与临床．天津：天津科技翻译出版公司，1992：68．
[33] 关章顺，吴俊，喻泽兰，等．荷叶水提物对人体高脂血症的降脂效果研究．郴州医学高等专科学校学报，2003，5(3)：3～6．
[34] Brewer HB. Hypertiglyceridemia: changes in the plasma lipoproteins associated with an increased risk of cardiovascular disease. Am J Cardiol, 1999, 83 (9B) : 3F～12F.
[35] 舒娟，吕卓人．血脂定量指标诊断价值的评估．临床心血管病杂志，1995，11(1)：46～46．
[36] Austin MA, Hokanson JE, Edwards KL. Hypertriglyceridemia as a cardiovascular risk factor. Am J Cardiol, 1998, 81 (4A) : 7B～12B.
[37] Austin MA. Epidemiology of hypertriglyceridemia and cardiovascular disease. Am J Cardiol, 1999, 83(9B) : 13F～16F.
[38] Cullen P, Shulte H, Assmann O. Smoking,lipoproteins and coronary heart disease risk: Data from the Münster Heart Study (PROCAM). Eur Heart J, 1998, 19(11) 1632～1641.
[39] Gurndy SM. Hypertriglyceridemia, atherogenic dyslipidemia and the metabolic syndrome. Am J Cardiol, 1998, 81 (4A) : 18B～25B.
[40] 李江，赵水平，李向平，等．辛伐他汀降脂治疗对血管内皮依赖性舒张功能的影响．中华心血管病杂志，1998，26(4)：278～281．
[41] Gould DL, Rossouw JE, Santanello NC, et al. Cholesterol reduction yields clinical benefit: Impact of statin trials. Circulation, 1998, 97: 946～952.
[42] Oliver MF. Cholesterol and stroke: Cholesterol lowing is indicated for strokes due to carotid atheroma. BMJ 2000, 320: 459～460.
[43] Lamendola C. Hypertriglyceridemia and low high-density lipoprotein: risks for coronary artery disease? J Cardiovasc Nurs, 2001, 14: 79～90.
[44] 韩梅，摘．高密度脂蛋白胆固醇与妇女冠心病的关系．国外医学：心血管疾病分册，2000，27(6)：370～371．
[45] Durrington PN, Mackness B, Mackness MI. Paraoxonase and atherosclerosis. Arterioscler Thromb Vasc Biol, 2001, 21: 473～480.
[46] Gordon T, Kannel WB, Castelli WP, et al. Lipoproteins, cardiovascular disease, and death. The Framingham study. Arch Intern Med, 1981, 141:1128～1131.
[47] Holme Ⅰ. An analysis of randomized trials evaluating the effect of cholesterol reduction on total mortality and coronary heart disease incidence. Circulation, 1990, 82: 1916～1924.
[48] 刘静，赵冬，秦兰萍，等．低密度脂蛋白胆固醇与心血管病发病关系的前瞻性研究．中华心血管病杂志，2001，29(9)：561～565．
[49] Francis GA, Tsujita M, Terry TL, et al. Apolipoprotein A_1 efficiently binds to and mediates cholesterol and phospholipid efflux from human but not rat aortic smooth muscle cells. Biochemistry, 1999, 38 (49) : 16315～16322.
[50] Fruchart JC, Brewer HB, Leitersdorf E. Consensus for the use of fibrates in the treatment of dyslipoproteinemia and coronary heart disease. Am J Cardiol, 1998, 81(7): 912～917.
[51] 葛善旭，刘欣，刘玉庆．心脑血管病患者血清ApoA_1、ApoB_(100)检测结果分析．中国医师杂志，2001，3(11)：860～861．
[52] AHA Committee Report. Risk factors and coronary disease. Circulation, 1980, 62(2): 449A～455A.
[53] Gotto AM. Statin Therapy: where are we? Where do we go next? Am J Cardiol, 2001, 87(suppl): 13B～18B.
[54] Frost PH, Havel RJ. Rationale for use of non-HDL cholesterol rather than LDL
cholesterol as a tool for lipoprotein cholesterol screening and assessment of risk and therapy.Am J Cardiol, 1998, 81 (4A) : 26B～31B.
[55] 赖奕光，黄承乐．脑卒中患者甘油三脂及非高密度脂蛋白胆固醇改变的研究．右江民族医学院学报，2001，23(4)：521～522．
[56] Ridker PM, Glynn RJ, Henneken CH. C-reactive protein adds to the predictive value of total and HDL cholesterol in determining risk of first myocardial infarction. Circulation, 1998, 97:2007～2011.
[57] 黄红漫，许其倓．他汀类调脂药对冠心病患者C反应蛋白的影响．上海第二医科大学学报，2002，22(5)：461～462．
[58] Guba SC, Fink LM, Fonseca V. Hyperhomocysteinemia, an emerging and important risk factor for thromboembolic and cardiovascular disease. Am J clin Pathol, 1996, 106(6) : 709～722.
[59] Antonio CM, Nunes MC, Refsum H, et al. A novel pathway for the conversion of homocysteine to methionine in eukaryotes. Biochem J, 1997, 328(1) : 165～170.
[60] Malinow MR. Plasma homocysteine:A risk factor for arterial occlusive disease. J Nutr, 1996, 126(4S) :1238S～1243S.
[61] 程小曲．痰浊型冠心病与血脂、脂蛋白、载脂蛋白的关系及痰浊形成机理的探讨．新中医，1994，26(3)：7～9．
[62] 宋剑南，刘东远，牛晓红，等．高脂血症与中医痰浊关系的实验研究．中国中医基础医学杂志，1995，1(1)：49～51．
[63] 黄可儿，方永奇，李小兵，等．高脂血症血液流变学改变及与中医分型的关系．新中医，1993，25(2)：6～8．
[2] Scandinavian Simvastatin Survival Study Group. Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study(4S). Lancet, 1994, 344: 1383～1389.
[3] Downs JR, Clearfield M, Whitney E, et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels. JAMA, 1998, 279:1615～1622.
[4] 陆国平，戚文航．冠心病的一级预防．新医学，2000，31(3)：13～14．
[5] Stein EA, Davidson MH, Dobs AS, et al. Efficacy and safety of simvaststin 80mg/day in hypercholesterolemia patients. Am J Cardiol, 1998, 82(3) :311～316.
[6] The Long-term Intervention with Pravastatin in Ischemic Disease(LIPID) Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med, 1998, 339(19) :1349～1357.
[7] 沈丽华，柯开富，李作汉，等．家族聚集性脑梗死发病与低密度脂蛋白胆固醇的相关性．中国临床康复，2003，7(31)：4246～4247．
[8] 尹巧香，赵玉生，陈真．代谢综合征与冠心病及血脂异常的相关性．中国临床康复，2003，7(21)：2916～2917．
[9] 金玉华，祝之明，李彦社，等．血脂紊乱对代谢综合征早期肾功能损害的影响．中国临床康复，2003，7(18)：2515～2517．
[10] Manninen V, Elo MO, Frik MH, et al. Lipid alterations and decline in the incidence of coronary heart disease in the Helsinki heart study. JAMA, 1988, 260:641～651.
[11] Shepherd J, Cobbe SM, Ford I, et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med, 1995, 333 (20) : 1301～1307.
[12] 沈桂英，龚树春．自拟祛脂丸治疗高脂血症43例疗效观察．浙江中医杂志，1997，32(1)，32～32．
[13] 龚一萍，王辛儿．高脂血症与心脉相关性探讨．北京中医药大学学报，2002，25(1)：62～63．
[14] 血脂异常防治对策专题组．血脂异常防治建议．中华心血管病杂志，1997，25(3)：169～175．
[15] Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults(Adult Treatment Panel Ⅲ).Executive Summary of the Third Report of the National Cholesterol Education Program(NCEP).JAMA, 2001, 285:2486～2497.
[16] 田国庆，梁晓春．高脂血症实用中西医结合内科学，陈可冀主编．北京医科大学中国协和医科大学联合出版社出版．1998年第1版，1278～1286．
[17] 刘国仪，胡大一，陶萍，等．心血管药物临床试验评价方法的建议．中华心血管病杂志，1998，26(1)：5～11．
[18] Larosa JC, He J, Vupputuri S. Effect of statin on risk of coronary disease: A meta-analysis of randomized controlled trials. JAMA, 1999, 282:2340～2346.
[19] 王治宽，孟海燕．从痰论治血脂异常浅析．中医药学刊，2004，22(1)：120～121．
[20] 陶晋舆，吕环，张秋菊，等．泽泻抗动脉粥样硬化作用系列研究(二)．北京中医学院学报，1991，14(6)：51～53．
[21] 沈奇桂，朱寿民．决明子对实验性高胆固醇血症和动脉粥样硬化的抑制作用及其机理探讨．浙江医科大学学报，1993，22(6)：246～249．
[22] 沃兴德，高承贤，洪行球，等．姜黄醇提取物对兔食饵性高脂血症的实验研究．浙江中医学院学报，1999，23(1)：16～18．
[23] 沃兴德，洪行球，魏佳萍，等．姜黄醇提取物对高脂血症患者脂代谢及肝肾功能的影响．浙江中医学院学报，1999，23(1)：20～22．
[24] 李小鹰，王培仁，邵建华，等．静脉注射葛根素对犬急性心肌梗塞范围的影响．山东医学院学报，1984，22(3)：9～16．
[25] 吕欣然，陈淑梅，孙塘．葛根素对β-肾上腺素能受体阻滞作用的研究．药学学报，1980，15(4)：218～221．
[26] 曹慧，周爽，方邦江，等．葛根素对自发性高血压大鼠血脂及层粘连蛋白的影
响．医学理论与实践，2003，16(3)：254～255．
[27] 华一俐，张融瑞，仇健明，等．中药桑寄生不同提取液的降脂作用研究．南京中医药大学学报，1995，11(2)：86～86．
[28] 李贵海，孙敬勇，张希林，等．山楂降血脂有效成分的实验研究．中草药，2002，33(1)：50～52．
[29] 潘娟华，倪立坚．丹参对血液系统及血脂作用的研究进展．海峡药学，1998，10(2)：79～79．
[30] 陶波，帅景贤，吴风莲．荷叶水煎剂对高血脂症大鼠血脂及血液流变学的影响．中医药学报，2000，28(6)：55～56．
[31] 龚康敏，历兰娜，姚雪梅，等．荷叶合剂对小鼠及高脂血症大鼠血脂代谢的研究．中国中医药科技，1998，5(5)：294～295．
[32] 李广勋．中药药理毒理与临床．天津：天津科技翻译出版公司，1992：68．
[33] 关章顺，吴俊，喻泽兰，等．荷叶水提物对人体高脂血症的降脂效果研究．郴州医学高等专科学校学报，2003，5(3)：3～6．
[34] Brewer HB. Hypertiglyceridemia: changes in the plasma lipoproteins associated with an increased risk of cardiovascular disease. Am J Cardiol, 1999, 83 (9B) : 3F～12F.
[35] 舒娟，吕卓人．血脂定量指标诊断价值的评估．临床心血管病杂志，1995，11(1)：46～46．
[36] Austin MA, Hokanson JE, Edwards KL. Hypertriglyceridemia as a cardiovascular risk factor. Am J Cardiol, 1998, 81 (4A) : 7B～12B.
[37] Austin MA. Epidemiology of hypertriglyceridemia and cardiovascular disease. Am J Cardiol, 1999, 83(9B) : 13F～16F.
[38] Cullen P, Shulte H, Assmann O. Smoking,lipoproteins and coronary heart disease risk: Data from the Münster Heart Study (PROCAM). Eur Heart J, 1998, 19(11) 1632～1641.
[39] Gurndy SM. Hypertriglyceridemia, atherogenic dyslipidemia and the metabolic syndrome. Am J Cardiol, 1998, 81 (4A) : 18B～25B.
[40] 李江，赵水平，李向平，等．辛伐他汀降脂治疗对血管内皮依赖性舒张功能的影响．中华心血管病杂志，1998，26(4)：278～281．
[41] Gould DL, Rossouw JE, Santanello NC, et al. Cholesterol reduction yields clinical benefit: Impact of statin trials. Circulation, 1998, 97: 946～952.
[42] Oliver MF. Cholesterol and stroke: Cholesterol lowing is indicated for strokes due to carotid atheroma. BMJ 2000, 320: 459～460.
[43] Lamendola C. Hypertriglyceridemia and low high-density lipoprotein: risks for coronary artery disease? J Cardiovasc Nurs, 2001, 14: 79～90.
[44] 韩梅，摘．高密度脂蛋白胆固醇与妇女冠心病的关系．国外医学：心血管疾病分册，2000，27(6)：370～371．
[45] Durrington PN, Mackness B, Mackness MI. Paraoxonase and atherosclerosis. Arterioscler Thromb Vasc Biol, 2001, 21: 473～480.
[46] Gordon T, Kannel WB, Castelli WP, et al. Lipoproteins, cardiovascular disease, and death. The Framingham study. Arch Intern Med, 1981, 141:1128～1131.
[47] Holme Ⅰ. An analysis of randomized trials evaluating the effect of cholesterol reduction on total mortality and coronary heart disease incidence. Circulation, 1990, 82: 1916～1924.
[48] 刘静，赵冬，秦兰萍，等．低密度脂蛋白胆固醇与心血管病发病关系的前瞻性研究．中华心血管病杂志，2001，29(9)：561～565．
[49] Francis GA, Tsujita M, Terry TL, et al. Apolipoprotein A_1 efficiently binds to and mediates cholesterol and phospholipid efflux from human but not rat aortic smooth muscle cells. Biochemistry, 1999, 38 (49) : 16315～16322.
[50] Fruchart JC, Brewer HB, Leitersdorf E. Consensus for the use of fibrates in the treatment of dyslipoproteinemia and coronary heart disease. Am J Cardiol, 1998, 81(7): 912～917.
[51] 葛善旭，刘欣，刘玉庆．心脑血管病患者血清ApoA_1、ApoB_(100)检测结果分析．中国医师杂志，2001，3(11)：860～861．
[52] AHA Committee Report. Risk factors and coronary disease. Circulation, 1980, 62(2): 449A～455A.
[53] Gotto AM. Statin Therapy: where are we? Where do we go next? Am J Cardiol, 2001, 87(suppl): 13B～18B.
[54] Frost PH, Havel RJ. Rationale for use of non-HDL cholesterol rather than LDL
cholesterol as a tool for lipoprotein cholesterol screening and assessment of risk and therapy.Am J Cardiol, 1998, 81 (4A) : 26B～31B.
[55] 赖奕光，黄承乐．脑卒中患者甘油三脂及非高密度脂蛋白胆固醇改变的研究．右江民族医学院学报，2001，23(4)：521～522．
[56] Ridker PM, Glynn RJ, Henneken CH. C-reactive protein adds to the predictive value of total and HDL cholesterol in determining risk of first myocardial infarction. Circulation, 1998, 97:2007～2011.
[57] 黄红漫，许其倓．他汀类调脂药对冠心病患者C反应蛋白的影响．上海第二医科大学学报，2002，22(5)：461～462．
[58] Guba SC, Fink LM, Fonseca V. Hyperhomocysteinemia, an emerging and important risk factor for thromboembolic and cardiovascular disease. Am J clin Pathol, 1996, 106(6) : 709～722.
[59] Antonio CM, Nunes MC, Refsum H, et al. A novel pathway for the conversion of homocysteine to methionine in eukaryotes. Biochem J, 1997, 328(1) : 165～170.
[60] Malinow MR. Plasma homocysteine:A risk factor for arterial occlusive disease. J Nutr, 1996, 126(4S) :1238S～1243S.
[61] 程小曲．痰浊型冠心病与血脂、脂蛋白、载脂蛋白的关系及痰浊形成机理的探讨．新中医，1994，26(3)：7～9．
[62] 宋剑南，刘东远，牛晓红，等．高脂血症与中医痰浊关系的实验研究．中国中医基础医学杂志，1995，1(1)：49～51．
[63] 黄可儿，方永奇，李小兵，等．高脂血症血液流变学改变及与中医分型的关系．新中医，1993，25(2)：6～8．